A dramatic account of the gruesome accidents that shaped modern neuroscience

Phineas Gage was a foreman with a crew of railroad navigators. One autumn day in Vermont, 1848, he was tamping down an explosive charge inside an overhanging rock outcrop when the powder ignited. The explosion turned the 3ft 7in rod into a missile, driving it clear through Gage’s skull and out the other side. Gage not only survived the accident but remained conscious, even during the bumpy oxcart ride to his lodgings where a local doctor examined him, later saying: “The parts of the brain that looked good for something, I put back in.”

Gage’s horrific story appears in the final chapter of Sam Kean’s book on the history of neuroscience to prove, at the very least, that some people can survive a large iron rod going straight through their head. Gage lost an eye, a deal of temporal lobe and, according to some contemporary accounts, underwent a personality change. Kean stresses the personality changes and portrays the new Gage as a dissolute drifter. For a time, he worked for P T Barnum’s American Museum, posing with his tamping rod in his hand.

The spirit of P T Barnum runs through Kean’s entertaining book, which recounts the most gothic of brain injuries as though the story of medicine is, at heart, a collection of gruesome curiosities. There are the cannibals of Papua New Guinea who developed a version of Creutzfeldt-Jakob disease known as Kuru from eating the brains of departed loved ones. Or the neurosurgeon who rewired the legs of lab rats, so left was right and right was left, and then made the animals dance on hotplates. We learn about Capgras Syndrome in which sufferers find the slightest change in the appearance of a loved one so difficult to accept; the only possible explanation must be that a near-perfect doppelganger has taken their place. Rather than boring old endnotes, Kean supplies “bonus material” of amazing facts and jokey asides. Among the illustrations and puzzles on every page I found a particularly instructive picture of a man with the size of his body parts changed to reflect the amount of brain space given over to their care: hands, lips and genitals are enormous.

This is a kind of Horrible Histories for adults, and by “adult” I mean, of course, the part of us that remains trapped in childhood, screeching yuk and urgh with glee. The title story tells how a shard of jousting lance pierced the head of Henri II. When his doctors realised that spoon-feeding the king parts of a mummified corpse was having little effect, two rival surgeons were called in: Andreas Vesalius and Ambroise Paré. The pair failed to save the king’s life, but their autopsy was crucial in the development of modern neuroscience. At no point, however, did Vesalius and Paré begin duelling. Kean suggests they “likely circled each other, sizing the other up”. Or maybe they did not. Kean is the kind of writer who would over-egg an omelette, and then drown the result in Béarnaise sauce. Most of his stories appear in other histories of neuroscience and, in comparison, Kean’s dramatisations lack nuance and doubt; it is by no means certain, for instance, that Gage underwent as drastic a personality change as Kean suggests. Far from being an inveterate drifter, he held a job driving a team of horses for much of the life he had left before he was incapacitated by convulsions.

Related Articles

Kean focuses on the mechanics of the mind. Consciousness, he suggests, is a kind of secondary quality of the brain’s functioning, just as wetness is a side effect of the agitation of water molecules. He quotes a scientist who dismisses the quest to explain consciousness as something pursued by “fools and Nobel laureates”; that is, eminent surgeons who have reached the end of their careers. Yet, as Kean notes, consciousness is all that we are really interested in. Whatever the brain might actually do, we care chiefly about what it feels as much as what it does: which is conjuring up our thoughts and dreams and delivering free will – or its illusion. Kean’s theatrical verve is engaging, but leaves one wishing for an account that has less of the horror show and a shade more philosophy.